Awareness and Change: How Psychodynamic Therapy Supports Healing

In a research study, it was discovered that therapists who practiced the core values of psychodynamic therapy had better outcomes for people who were suffering from depression—regardless of the type of therapy the therapist thought they were providing.¹ In other words, when therapists followed psychodynamic practices, this resulted in more successful health outcomes even if the therapist believed they were practicing other therapeutic interventions.

Regardless of how psychotherapists label themselves, therapists who emphasize self-awareness and emotional expression, tend to deeper-rooted issues, and create successful working relationships with clients can help facilitate meaningful change. While psychodynamic therapy is not the only therapeutic modality that holds these therapeutic values, the origination of these concepts can all be traced to psychoanalysis.

Psychodynamic psychotherapy specializes in fostering greater self-awareness for people who are suffering from a range of symptoms associated with depression, grief, anxiety, relationship issues, identity concerns, difficult family dynamics, self-esteem, self-defeating patterns, and many other stress-related psychosomatic difficulties. This framework for healing prioritizes the understanding of unconscious processes within our lives and has been validated by scientific research in the last 15 years which supports its effectiveness.^2,3,4 In fact, neuroscience and cognitive science are now providing a scientific foundation for many of the practices that have been around for decades within psychoanalytical circles.⁵

Why Do Some Professionals Avoid Psychodynamic Therapy?

Despite this research, some mental health professionals continue to remain hostile towards depth-oriented approaches. However, the ignorance towards psychodynamic therapy from some mental health professionals is ironic, given the fact that psychodynamic therapy would likely be effective in helping tend to their own blind spots.

Anecdotally, it has been my experience that some mental health providers who demonstrate disdain towards psychodynamic therapy have surprisingly never actually experienced psychodynamic therapy themselves. Others have never reviewed the scientific literature on psychodynamic therapy, which is not always their fault, as many psychotherapists or counsellors have no access to research hidden behind paywalls. Barriers that inhibit access to research (paywalls, institutional affiliations, etc.) ought to be addressed to support therapists having up-to-date information, further ensuring that treatment decisions are rooted in evidence.

Some mental health professionals are also blindly following their introduction to psychology courses from half a century ago where academic psychologists (who are not practicing therapists) would exclusively focus on teaching students quirky theories like id, ego, and superego, rather than recent scientific developments in psychodynamic psychotherapy. It is not challenging to find psychodynamic or psychoanalytical therapies being misrepresented in many university or college-level courses. For some reason, many analytical trailblazers are also never mentioned in these texts or courses in a meaningful way, like Klein, Jung, Bowlby, Ainsworth, Winnicott, and others.

It also is not difficult to find unrealistic examples of psychoanalytical or psychodynamic therapy in popular culture that exclusively focus on some of Freud’s most wild speculations. Thankfully, robust amounts of research around psychodynamic therapy are challenging unrealistic and dramatic portrayals.

Psychodynamic approaches have evolved significantly since Sigmund Freud. The current distinctive feature of psychodynamic psychotherapy is that it creates awareness around unconscious processes that shape personality development and overall functioning. Psychological symptoms have deeper meanings, and by cultivating insights around disorienting psychological experiences, both clinicians and people who are suffering can change underlying processes that result in health issues or problematic behaviours.

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What Are Some of the Core Features of Psychodynamic Therapy?

Deeper awareness is the cornerstone for all change. Without conscious awareness, boundaries, choice, or self-agency do not authentically exist. Other key elements of modern psychodynamic or psychoanalytical therapy include:

• Identifying and changing re-occurring patterns within a person’s life, which may be conscious or unconscious.
• Facilitating emotional insight and deeper introspection, instead of focusing only on logical understanding.
• Exploring people’s survival responses or tendencies around avoiding distressing thoughts and feelings.
• Recognizing that identity development is a highly relational experience, influenced by the attachment system which stems from childhood and ongoing family or relational dynamics with partners.
• Using the working relationship between people and their therapists to help facilitate positive, long-lasting change.
• Working with a mind in conflict, as people often have many opposing feelings and thoughts about challenging experiences.
• Honouring dreams, fantasies, art, and other forms of embodied expression to connect more deeply to the human experience.

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It is essential to recognize that psychodynamic therapists do not talk about the past or people’s childhood simply for fun. Instead, it is because the past lives on in the present, and if people want to relearn how to be in the world, individuals must engage in the heroic quest of tending to lifelong patterns. The intention of visiting the past is always to help people live more liberated lives in the present and to help people cultivate radically authentic lives. So, it turns out that talking about your childhood can be a valuable experience.

Emotional fluidity also allows a greater range of responses, as well as choices within life. After all, many intelligent people can discuss their challenges in life, and yet rational reasoning alone does not help people overcome self-defeating patterns or deeper psychological struggles.⁶ Focusing on emotional anguish is key within effective forms of talk therapy.

The practice of deep listening, non-judgmental presence, and ongoing curiosity on behalf of the therapist via unstructured talk therapy helps individuals tune into their own unique capacity for insight and connection. Effective psychotherapy is not about the therapist healing you, but rather helping you deeply connect to yourself, as healing can emerge from within the mind and body.

It is through the eyes of the other (i.e., the therapist), that we come to know ourselves. This tangible relationship also actively heals deep relational wounding, originally demonstrated by attachment theory and object relations. Any serious form of talk therapy now centralizes the interpersonal relationship between the person who is suffering and their therapist.

While therapy is becoming more common, it is also essential that effective evidence-based therapy is being provided. That is exactly why psychodynamic therapy has survived—it has a proven history of working for diverse people for decades. People respond well to traditions of psychotherapy that can work with subtlety, complexity, and nuance.